The CQC, which is responsible for checking and regulating hospitals and care providers, inspected the ambulance trust at the end of January and published its report today.

It found ambulance response times had deteriorated since the last inspection, and that "people could not be assured they would receive care in a timely and effective manner".

The trust will now have to compile a report before March 27, setting out the action they will take to improve.

The CQC assessed five standards, and found the trust was not meeting the standard for care and welfare of people who use the service.

The report read: "Response times to emergency calls were an area of concern following our previous inspection in March 2012.

"We were also aware prior to this inspection that the trust's performance had deteriorated during 2012."

The two standards for emergency response times are known as A8 and A19.

The first states three quarters of the highest priority calls must be attended within eight minutes.

The second sets out the target for the attendance of a fully equipped ambulance if the patient needs to be taken to hospital. In this instance, 95 per cent must be attended within 19 minutes.

The report continues: "Figures supplied to us by the trust for April 2012 to December 2012, confirmed it was not meeting the response times for A8 and A19 calls for the trust as a whole.

"There continues to be a significant inequity of service between rural and urban areas of the trust."

Other criticisms included the trust’s ability to take people who had suffered a stroke to a specialist centre within 60 minutes, an area of concern at the previous inspection, had not improved significantly.

Staff members interviewed told the inspectors that there had been a nine per cent increase in calls over the past 12 months, but there were not enough staff to cover this.

Andrew Morgan, trust interim chief executive, said: "I recognise that our performance and response times are simply not good enough.

"That is why we are recruiting more front line staff and seeking to put more ambulances out on the road, whilst also seeking to reduce the delays we experience in handing over patients at hospitals.

"Whilst we are funded to hit a regional target, performance in more rural areas also needs to improve and we are currently in talks with our commissioners to address this issue.

"Our staff work hard day and night to provide the best possible care for patients, as reflected in some very positive feedback from the CQC in this report.

"I believe that we can harness the passion of our staff with the plans we have put in place and we will start showing steady improvements over the coming months."

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